Temporal profile and prognostic value of Lp-PLA2 mass and activity in the acute stroke setting
Temporal profile and prognostic value of Lp-PLA2 mass and activity in the acute stroke setting
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DOI：
10.1016/j.atherosclerosis.2011.11.016
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发表时间：
2012-02-01
期刊：
影响因子：
5.3
通讯作者：
Montaner, Joan
中科院分区：
文献类型：
--
作者：
Delgado, Pilar;Chacon, Pilar;Montaner, Joan
背景：脂蛋白磷脂酶A2是一种新的心血管疾病的生物标志物，因为它能够预测首次和复发性卒中。关于其对卒中后早期结局的影响，目前还知之甚少。目的：我们的目的是研究脂蛋白-磷脂酶A2在t-PA治疗的卒中患者中的作用，并研究其与早期结局的关系。研究方法：在135名健康对照者和接受t-PA治疗的中风患者中，通过在自动Olympus分析仪上进行PLAC试验和比色活性法（diaDexus），在基线（n = 99）和此后连续（n = 34）测量Lp-PLA 2质量和活性。连续记录NIHSS评分和TCD记录。结果被定义为根据早期的神经系统状态，存在动脉再通和功能的结果，在第三month.Results：Lp-PLA 2质量增加相比，对照组，而Lp-PLA 2活性显着下降，在基线与对照组相比，与1和24小时的测定。Lp-PLA 2的质量和活性与早期（48小时）的神经功能状态无关。关于再通，在t-PA治疗结束时未实现完全再通的患者中发现了较高的质量和活动（质量p = 0.029，活动p = 0.044）。Lp-PLA 2质量和基线时近端闭塞的存在是持续性闭塞的最有力预测因素（近端闭塞的OR为6.8。P = 0.036，Lp-PLA 2质量的OR为7.2/标准差增加，P = 0.008）。Lp-PLA 2质量可能增加静脉t-PA治疗的卒中患者早期动脉再通的相关信息。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Background: Lp-PLA2 is a novel biomarker in cardiovascular diseases due to its ability to predict first-ever and recurrent stroke. Little information is known regarding its influence on early outcome after stroke.Objectives: We aimed to investigate Lp-PLA2 in t-PA-treated stroke patients and to study its relationship with early outcome. Methods: Lp-PLA2 mass and activity were measured in 135 healthy controls and also in stroke patients treated with t-PA at baseline (n = 99) and serially thereafter (n = 34) by means of the PLAC test at an automated Olympus analyzer and by a colorimetric activity method (diaDexus). NIHSS scores and TCD recordings were also obtained serially. Outcome was defined according to early neurological status, the presence of arterial recanalization and functional outcome at third month.Results: Lp-PLA2 mass was increased as compared to controls, whereas Lp-PLA2 activity was significantly decreased at baseline as compared with controls and with 1 and 24 h determinations. Lp-PLA2 mass and activity were not related with early (48 h) neurological status. Regarding recanalization, higher mass and activity were found among patients who did not achieve complete recanalization by the end of t-PA treatment (p = 0.029 for mass, p = 0.044 for activity). Lp-PLA2 mass and the existence of a proximal occlusion at baseline were the most powerful predictors for persistent occlusions (OR for proximal occlusion 6.8. p = 0.036, OR for Lp-PLA2 mass 7.2 per standard deviation increase, p = 0.008).Conclusions: Significant changes in Lp-PLA2 concentrations occur early after stroke onset. Lp-PLA2 mass may add relevant information regarding early arterial recanalization in intravenous t-PA-treated stroke patients. (C) 2011 Elsevier Ireland Ltd. All rights reserved.